長期照護機構高風險群老人跌倒因素與防跌課程介入成效之探討

Risk Factors Associated with Falling and the Effects of Fall Prevention Programs for the Elderly in Long-Term Care Institutions

曾雅梅(Ya-Mei Tseng) ； 余承萍(Cheng-Ping Yu) ； 賴冠郎(Kuan-Lang Lai) ； 高森永(Sen-Yeong Kao)

《台灣公共衛生雜誌》 31卷3期 (2012/06) Pp. 263-276

https://doi.org/10.6288/TJPH2012-31-03-06

摘要

Objectives: The prevention of falls in elderly adults is an important issue. The aims of this study were to investigate the risk factors for falling and the effects of fall prevention programs for the high risk elderly in long-term care. Methods: There were two stages in this study from 2009/09 to 2010/2. In the first, we collected data on demographics, health status, history of falling, the geriatric depression scale, knowledge and behavior about preventing falls, and the mini-mental status examination (MMSE) with a structured questionnaire. The second stage was a pre-post study design with a 12 week fall prevention program that included health education and exercise. Results: The first stage was a cross-sectional study design and involved a sample of 286 aged 65 and older, high risk elderly. Of these, 33.9% had fallen at least one or more times in the past year. The main risk factors were use of analgesics (OR=3.75, 95%C.I=1.40-10.01), use of hypnotics (OR=2.71, 95%C.I=1.32-5.57), no regular exercise (OR=2.19, 95%C.I=1.00-4.68) and avoidance of activity due to a fear of falling (OR=2.61, 95%C.I=1.39-4.91). In the second stage, 69 subjects completed the 12-week fall prevention program which focused on reduction of the incidence and fear of falling, improvement in health-related quality of life, ability to balance, and strengthening the lower-extremities. Conclusions: The fall prevention program improved fear of falling, quality of life, and partial body function among the elderly in long-term care institutions. This study offers our suggestions and clinical interventions as the basis for future studies with more subjects in other long-term care institutions.

關鍵字

長期照護機構 ； 高風險老人 ； 跌倒 ； 危險因子 ； 預防跌倒課程

並列摘要

Objectives: The prevention of falls in elderly adults is an important issue. The aims of this study were to investigate the risk factors for falling and the effects of fall prevention programs for the high risk elderly in long-term care. Methods: There were two stages in this study from 2009/09 to 2010/2. In the first, we collected data on demographics, health status, history of falling, the geriatric depression scale, knowledge and behavior about preventing falls, and the mini-mental status examination (MMSE) with a structured questionnaire. The second stage was a pre-post study design with a 12 week fall prevention program that included health education and exercise. Results: The first stage was a cross-sectional study design and involved a sample of 286 aged 65 and older, high risk elderly. Of these, 33.9% had fallen at least one or more times in the past year. The main risk factors were use of analgesics (OR=3.75, 95%C.I=1.40-10.01), use of hypnotics (OR=2.71, 95%C.I=1.32-5.57), no regular exercise (OR=2.19, 95%C.I=1.00-4.68) and avoidance of activity due to a fear of falling (OR=2.61, 95%C.I=1.39-4.91). In the second stage, 69 subjects completed the 12-week fall prevention program which focused on reduction of the incidence and fear of falling, improvement in health-related quality of life, ability to balance, and strengthening the lower-extremities. Conclusions: The fall prevention program improved fear of falling, quality of life, and partial body function among the elderly in long-term care institutions. This study offers our suggestions and clinical interventions as the basis for future studies with more subjects in other long-term care institutions.

並列關鍵字

long-term care institution ； high risk elderly ； falls ； risk factor ； fall prevention program

參考文獻

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